[The experience of a health centre undergoing an ecological transition]. / Établissement en transition écologique, retour d'expérience.

A health centre and its staff have undertaken a sustainable health approach which aims to reduce the impact of the environment on health. One of the initiatives focused on the improvement of indoor air quality. A change to practices was possible thanks to a participative approach, the support of the staff and constant communication.

Better for Patients, or Better for Business-Do We Really Have To Choose?

A trend that is likely to continue in 2018 is the rise of consumerism and expansion of the consumer-driven marketplace. But investing in this is pricey and in an era of shrinking margins is "better for patients" always "better for business?" The Advisory Board's Zachary Hafner answers with a resounding "yes!"

Monitoring quality at scale: implementing quality assurance in a diverse, multicountry HIV program.

The centrality of quality as a strategy to achieve impact within the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has been widely recognized. However, monitoring program quality remains a challenge for many HIV programs, particularly those in resource-limited settings, where human resource constraints and weaker health systems can pose formidable barriers to data collection and interpretation. We describe the practicalities of monitoring quality at scale within a very large multicountry PEPFAR-funded program, based largely at health facilities. The key elements include the following: supporting national programs and strategies; developing a conceptual framework and programmatic model to define quality and guide the provision of high-quality services; attending to program context, as well as program outcomes; leveraging existing and routinely collected data whenever possible; developing additional indicators for judicious use in targeted, in-depth assessments; providing hands-on support for data collection and use at the facility, sub-national, and national levels; utilizing web-based databases for data entry, analysis, and dissemination; and multidisciplinary support from a large team of clinical and strategic information advisors.

Supporting the massive scale-up of antiretroviral therapy: the evolution of PEPFAR-supported treatment facilities in South Africa, 2005-2009.

BACKGROUND: South Africa has an estimated 1.5 million persons in need of antiretroviral therapy (ART). In 2004, the South African government began collaborating with the United States President's Emergency Plan for AIDS Relief (PEPFAR) to increase access to ART. We determined how PEPFAR treatment support changed from 2005-2009. METHODS: In order to describe the change in number and type of PEPFAR-supported ART facilities, we analyzed routinely collected program-monitoring data from 2005-2009. The collected data included the number, type and province of facilities as well as the number of patients receiving ART at each facility. RESULTS: The number of PEPFAR-supported facilities providing ART increased from 184 facilities in 2005 to 1,469 facilities in 2009. From 2005-2009 the number of PEPFAR-supported government facilities increased 10.1 fold from 54 to 546 while the number of PEPFAR-supported NGO facilities (including general practitioner and NGO facilities) increased 6.2 fold from 114 to 708. In 2009 the total number of persons treated at PEPFAR-supported NGO facilities was 43,577 versus 501,089 persons at PEPFAR-supported government facilities. Overall, the median number of patients receiving ART per site increased from 81 in 2005 to 136 in 2009. CONCLUSIONS: To mitigate the gap between those needing and those receiving ART, more facilities were supported. The proportion of government facilities supported and the median number of persons treated at these facilities increased. This shift could potentially be sustainable as government sites reach more individuals and receive government funding. These results demonstrate that PEPFAR was able to support a massive scale-up of ART services in a short period of time.

Evaluación del sistema de información de seguridad del paciente de los centros sanitarios del Servicio Madrileño de Salud (Atención Primaria y Hospitales) / Assessment of Patient Safety reporting system in Madrid Health Services (Primary Care and Hospitals)

Objetivos. Mejorar el sistema de información de seguridad del paciente de las unidades funcionales de gestión de riesgos sanitarios (UFGRS) de los centros del Servicio Madrileño de Salud; analizando la opinión de las UFGRS sobre el contenido, cumplimentación y utilidad, detectando las dificultades e identificando las áreas de mejora. Método. Se ha realizado un estudio descriptivo mediante cuestionarios dirigidos a las 45 UFGRS de los centros sanitarios del Servicio Madrileño de Salud. Resultados. El cuestionario, en una escala de 1 a 5, obtuvo respuestas en promedios superiores a 3,70 en: los contenidos (3,77), la forma de cumplimentar (3,72) el formulario; la claridad en la exposición de los datos del informe (3,94) y en la utilidad global de la información (3,77). Las dificultades detectadas más significativas estaban relacionadas con el exceso y reiteración de información solicitada. En las áreas de mejora destacan la demanda de mayor depuración y análisis de información sobre prácticas seguras, la realización de dos formatos de informe de resultados para facilitar la difusión en los centros y la revisión de la clasificación de incidentes de seguridad. Conocer la opinión de las unidades funcionales sobre el sistema de información permite mejorar la utilidad del mismo en cuanto a la accesibilidad, presentación e intercambio de la información en materia de seguridad del paciente(AU)

Objectives. Improve the patient safety reporting system of the Functional Units of Health Risk Management (UFGRS) in Madrid health services, analysing the opinion of the UFGRS about its content, completion and usefulness, detecting the difficulties and identifying the areas for improvement. Method. A descriptive study was conducted using a questionnaire addressed to the 45 UFGRS of the Madrid Health Services. Results. The questionnaire, with a scale of 1 to 5, received responses with an average higher than 3.70: contents (3.77); how to complete the form (3.72); clarity of data shown in the report (3.94) and the overall usefulness of the information (3.77). The most significant difficulties found were related to the excess and reiteration of the information requested. As regards areas for improvement, the most notable was the demand for more refining and analysis of the information about safe practices, the execution of two types of format for reporting results in order to facilitate dissemination among the centres and the review of the classification of safety incidents. Knowing the opinion of the Functional Units of the information system may improve the usefulness of the report as far as accessibility, presentation and exchange of information on patient safety is concerned(AU)

Familiarity with modern health management trends by West African surgeons.

OBJECTIVES: To collate the self-reported assessment of familiarity with some aspects of managerial competencies on the part of some surgeons and their observations on the managerial environment of their health institutions and draw appropriate policy implications. DESIGN: Cross-sectional study using a structured questionnaire. SETTING: The study was conducted during the 50th Annual Scientific Conference of the West African College of Surgeons, which was held in Calabar, Nigeria, from 6th to It 12th February 2010. SUBJECTS: One hundred and ten out of 150 surgeons who were attending the conference returned their filled questionnaires. RESULTS: Their familiarity with business and financial concepts was lacking on crucial ones related to marketing strategies. Respondent largely found the listed objections to advertisement of medical services as very appropriate. They preferred largely to interact with themselves in professional associations rather than with others in cross-cultural groupings. Funding (66.4%) and political/ethnic influences (43.9%) were rated as impacting very negatively on their health institutions, while the deployment of information communication technology to institutional processes was adjudged to be unsatisfactory. CONCLUSIONS: Most of the indices of core competencies in modern health leadership and management appeared deficient among our study participants and their health institutions managerial environments were equally deficient. We recommend for a well-focussed short time duration health management course for all physicians particularly specialists.

La gestión del conocimiento en sanidad / No disponible

No disponible

Gestión de calidad total en el Pius Hospital de Valls: Dirección por procesos, mejora permanente y gestión clínica (1ª parte) / Total Quality Management of the Pius Hospital in Valls (1ª part)

No disponible

No disponible